Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID.

Kyung-Ah Kim,Gwang Hyun Choi,Sook-Hyang Jeong,Sung Bum Cho,Youn Jae Lee,Moran Ki,Dahye Paik,Young Seok Kim,In Hee Kim,Hwa Young Choi,Eun Sun Jang

doi:10.4178/epih.e2021077

Abstract

OBJECTIVESInjection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).METHODSWe used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).RESULTSAmong the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.CONCLUSIONSAs of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.

Highlights

Hepatitis C virus (HCV) infection affects approximately 70 million people worldwide and is a major cause of liver cirrhosis and hepatocellular carcinoma (HCC) [1]
The population at high risk of HCV infection includes people who inject drugs (PWID), people with humen immunodeficiency virus (HIV) infection, men who have sex with men, people with a history of transfusion before HCV screening, children born to mothers infected with HCV, and people who have undergone tattooing or piercing
PWID accounted for 6.7% (166/2,468) of the subjects with HCV infection in Korea

Summary

Introduction

Hepatitis C virus (HCV) infection affects approximately 70 million people worldwide and is a major cause of liver cirrhosis and hepatocellular carcinoma (HCC) [1]. The status of the “HCV cascade of care” is far from the goal declared by the World Health Organization, which is the elimination of HCV by 2030 by diagnosing, treating, and preventing > 90%, > 80%, and 90% of new infections, respectively [3]. The proportion of PWID among those with HCV infection is 8.5% globally, with a wide variability from 0.9% to 46.6% among countries [7]

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